基于真实世界的慢性胰腺炎后糖尿病降糖治疗处方模式探索  

Glucose-lowering treatment for post-chronic pancreatitis diabetes mellitus:a real-world data-based approach

作　　者：赵琪 曹裕 叶鋆 陶红 潘妍羽 李一凡 谢金金 廖专 陈佳云 Zhao Qi;Cao Yu;Ye Jun;Tao Hong;Pan Yanyu;Li Yifan;Xie Jinjin;Liao Zhuan;Chen Jiayun(Department of Gastroenterology,First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院消化内科,上海200433

出　　处：《中华糖尿病杂志》2025年第2期244-250,共7页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：国家自然科学基金(82270674);军队护理创新与培育专项计划(2021HL028)。

摘　　要：目的探索真实世界中慢性胰腺炎后糖尿病(PPDM-C)的降糖治疗处方模式。方法为横断面研究。收集并筛选出2018年1月至2023年3月就诊于海军军医大学第一附属医院消化内科的PPDM-C患者,收集研究对象性别、入院时降糖治疗处方情况、入院时糖化血红蛋白(HbA_(1c))。按照入院时降糖治疗处方情况,将研究对象分为未治疗组、单纯口服降糖药组、单纯胰岛素组和胰岛素+口服药联用组4组。根据HbA_(1c)结果将HbA_(1c)>7%定义为血糖控制不佳,HbA_(1c)≤7%定义为血糖控制良好。采用单因素方差分析或χ^(2)检验进行组间比较。结果最终纳入386例PPDM-C患者。其中,未治疗组103例(26.7%)、单纯口服降糖药组135例(35.0%)、单纯胰岛素组107例(27.7%)、胰岛素+口服药联用组41例(10.6%);其中,男性314例(81.3%),224例PPDM-C患者(58.0%)血糖控制不佳。103例未治疗组PPDM-C患者中,血糖控制不佳者高达68.0%(70/103)。对研究对象血糖控制情况进行分析,结果显示,单纯口服降糖药组血糖控制良好的比例[59.3%(80/135)]均高于未治疗组[32.0%(33/103)]、单纯胰岛素组[32.7%(35/107)]及胰岛素+口服药联用组[34.1%(14/41)](均P<0.05)。结论真实世界中,PPDM-C患者血糖控制不够理想,治疗不够规范,尚无统一的降糖治疗处方模式。ObjectiveTo explore the real world model of hypoglycemic treatment for post-chronic pancreatitis diabetes mellitus(PPDM-C).MethodsThis was a cross-sectional study.Patients with PPDM-C who visited the Gastroenterology Department of First Affiliated Hospital of Naval Medical University from January 2018 to March 2023 were collected and screened.Data on sex,current glycemic control treatment prescriptions,and glycated hemoglobin(HbA_(1c))levels at admission were collected.Patients were divided into four groups based on their glycemic control treatment prescriptions at the time of their admission:untreated group,oral hypoglycemic medication-only group,insulin-only group,and combined insulin and oral medication group.Poor glycemic control was defined as HbA_(1c)>7%,and good glycemic control as HbA_(1c)≤7%.One-way analysis of variance orχ^(2) test were used for comparison between groups.ResultsA total of 386 PPDM-C patients were included in the study.Among them,there were 103 cases(26.7%)in the untreated group,135 cases(35.0%)in the oral hypoglycemic medication-only group,107 cases(27.7%)in the insulin-only group,and 41 cases(10.6%)in the insulin combined with oral medication group.Within the 386 PPDM-C patients,314(81.3%)were male,and 224 patients(58.0%)had poor glycemic control.Among the 103 untreated PPDM-C patients,68.0%(70/103)had poor glycemic control.Analysis of glycemic control in the study subjects showed that the proportion of patients with good glycemic control in the oral hypoglycemic medication-only group[59.3%(80/135)]was higher than in the untreated group[32.0%(33/103)],insulin-only group[32.7%(35/107)],and combined insulin and oral medication group[34.1%(14/41)](all P<0.05).ConclusionIn the real world,glycemic control in patients with PPDM-C is not ideal,treatment is not standardized,and there is no unified prescription pattern for glycemic control treatment.

关 键 词：糖尿病 慢性胰腺炎 真实世界研究 降糖治疗 

分 类 号：R576[医药卫生—消化系统] R587.1[医药卫生—内科学]